altered mental status

Question 1

deep dreamlike state from which one cannot be aroused

Answer 1

coma

Question 2

awake but responds to commands only

Answer 2

lthargic

Question 3

appears asleep, responds to light glabellar tap/stimulus

Answer 3

obtunded

Question 4

appears alseep, very sluggish

Answer 4

stuperous

Question 5

appears awake, but nonresponsive

Answer 5

vegetatitve state

Question 6

few voluntary movements, will blink in response to visual threat, resist eyelid elevation

Answer 6

catatonia

Question 7

pt awake but can only move eyes/eyelids

Answer 7

CPM

Question 8

causes of coma

lesions that damage ___ in thalamus or projections

pupils enlarged, loss of light reflex, loss vertical/adduction mvmnt
lesion is in ___

eye mvmnt preserved but as before, lesions is to ___

Answer 8

RAS

upper brainstem

upper cerebral hemisphere

Question 9

cause of com

destruction of large portion of both ____

suppression via __/___

Answer 9

cerebral hemispheres

drugs/metabolism

Question 10

when uncus impacts tentorial opening just anterior/adjacent to midbrain
___ herniation

displaced brain tissue compresses ___ as it traverse the SA space

results in enlagred ___, w coma

Answer 10

uncal tentorial

midbrain

ipsilateral pupil

Question 11

symmetric downward movement of thalamic medial structures through tentorial opening w compressed upper midbrain

mitotic pupils/drowsiness

___ herniation

Answer 11

central transtentorial herniaton

Question 12

Cerebral neurons depend on ___/___

coma from H/I/H/H
__/__ failure
altered ____

Answer 12

oxygen/glucose

hypoxia/isheia/hypoGly/hyperosmolarity
hepatic/reanl
neuron excitability

Question 13

dec flexion of elbow/wrists and supination of arms
___ rigidity

suggests bilateral damage __ to midbrain

dec extension of wrists/elbows w pronation
___ rigidity
damage to __ or caudal __

Answer 13

decorticate
rostral

decerebrate
midbrain, diencephalon

Question 14

one enlarged pupil suggest mass effect compressing __

bilaterla fixed/dilated pupils suggests sevre ___

pinpoint pupils w __/__ OD or __ hemorrhage

Answer 14

CN3

midbrain damage
Pons

Question 15

conjugate horizontal ocular deviation indicates damage to __ on other side, or __ on same side

brisk downward, slow upward movement of eyes, loss of horizontal eye mvmnt
Bilateral __ damage

Answer 15

pons, frontal lobe

pontine

Question 16

positive dolls eyes reflex

need __ motor nuclei and connections to __/_/__

suggests reduced __ on brainstem

Answer 16

ocular
MB/Pons/Medulla

cortical influence

Question 17

Caloric stimulation to induce ___ in labrynths

will have tonic deviation of ___ to side of cool water w ___ in opposite

loss indicates damage to __
absence of nystagmus suggest __ damage

Answer 17

convection currents
both eyes, nystagmus
brainstem
cerebral hemispheres

Question 18

shallow, slow, regular breathing

suggests __/__

Answer 18

met/drugs

Question 19

cyclic w apnea is ___

suggest __ damage or __ w light coma

Answer 19

CS

bihemospheral damage/metabolic

Question 20

rapid, deep breathing is __

seen w ___

Answer 20

Kussmaul

Macid

Question 21

terminal respirations, agonal gap w ___ damage

Answer 21

medullary